The Friday Five: Issues that Complicate HIV/AIDS in Western Kenya

HIV/AIDS is complex. A horrific disease that affects all parts of life, it is also specific in that in attacks a community in a multitude of ways. No region is exactly the same in how it is affected by HIV, and so our approaches to combating it require us to apply contextual approaches to each individual community.

No where is HIV/AIDS so prolific and total as in rural Africa. In the Lwala region of western Kenya, 24% of the population is HIV positive. Here is a peek into one of the places where HIV is rampant - and five issues that complicate the problem.

1. Polygamy It is still common for some tribes to observe the Old Testament practice of polygamy. If one member of the marriage is HIV positive, it passes to everyone else. Concurrent sexual relationships give flame to a fire that becomes difficult to stop.

2. Circumcision Most baby boys in western Kenya are not circumcised. However, studies show that HIV transmission is reduced up to 70% for men who are circumcised. There are significant efforts being made in the region to encourage voluntary adult male circumcision.

3. Maternal/Child Health In the region where we work in Lwala, Kenya, only 35% of women deliver their children with a skilled attendant or qualified nurse. Sufficient medical care is essential during labor and delivery in order to prevent transmission from mother to child, and unfortunately, it often comes too late or not at all.

4. Gender Inequality Women in Africa are not valued as highly as men. They are not given equal access to education and employment. They are seen more as property than as valuable citizens. Because of this vast gender inequality, most women lack the ability to say no to a man, even if he is her husband. The population at greatest risk for HIV is married African women. In Lwala, 67% of our HIV patients are women.

5. Stigma HIV/AIDS is our modern-day leprosy. It drips with shame and fear, making it extremely difficult for people to be open about their status. The fear associated with HIV/AIDS breeds ostracizing and hateful acts and so people continue to live in fear, full of guilt and shame and hiding their disease. Even more, when HIV/AIDS is kept secret by individuals, it prevents a community's ability to address the issue together - to speak about prevention and provide treatment in a safe and caring environment.

This list could go on and on. But the good news is that Lwala and other communities in Africa are not alone in their fight against HIV/AIDS. To learn more about how Blood:Water Mission partners with communities in Africa to address the HIV/AIDS crisis, click here. To learn more about our partner in Lwala, Kenya, Lwala Community Alliance, visit their website here.

*Photo Credit: Chris Pereira for Lwala Community Alliance.

Slowly by Slowly. Brick by Brick.

This is post 6 of 10 in the Broken:Beautiful series.                             

To get perspective on a New Jerusalem, we examine the land in which we work. If you look at the amount of time it takes in Africa for corn to grow or for a boy to walk his cattle to the nearest watering hole, you will find that the pace of life and growth of people follow the pace and growth of the land. Contrary to the speed at which electronic information travels or our genetically modified food grows here, we can only expect a slow-paced change and approach in Africa.

In Kenya, they say pole pole, or slowly by slowly. In Zambia, they say panono panono, brick by brick. And truly, that is what characterizes this work. Slowly by slowly we see that Africans are given access to healthcare, to education, to dignity, to opportunity. Brick by brick, there are hospital wings and rain catchment tanks and latrines being built that one by one, slowly by slowly, bring a taste of the new heavens and new earth to both those who live in poverty and to those whose material abundance have made them spiritually poor. We have come to see that the true transformation lies in this slowly by slowly process, a grassroots approach that truly honors the I-Thou relationship, that allows the communities to believe in their own capabilities and take ownership of their own development. It is a daily fight of endurance, courage, and resilience that we see in our friends who wage the long defeat. We are reminded of the new heavens and new earth in the specific stories of place and people and we are inspired in the slow and patient work of ushering in that kingdom.

Pretending to Dance

This is post 5 of 10 in the Broken:Beautiful series. Guest post by James Nardella.

I remember one Friday evening in the village, a night before the Sabbath for the Seventh Day Adventists in Lwala. The members of the church choir walked from homesteads near the hospital compound, to sing, to dance, to praise their God.

As I listened that night, I was taken in, enamored by their otherness. I danced with them, drawn in by the desire to belong. But I did not understand the Dhulou words to their songs and as they were translated I realized that I did not honestly know the sentiment that sings them.

The choir sang of a gospel familiar with exhaustion, sickness, hard labor. Their voices rejoiced that someday those burdens would be lifted, that in the New Creation all will be liberated. Jesus leads the way to a well-deserved place of freedom. Their lyrics confess that they cannot do life alone, and my Kenyan friends mean it.

I do not know this place they sing from, and yet, I see the gospel come to life in their worldview. This is the gift of being among the poor: that I have reaped their view, in as much as such a thing is possible, that the gospel is for those who are desperate, who know that life is going willy nilly and that not much is as it should be. It is by nature, good news to the poor, and it is folly for those of us who think we have it all together, or think we might get it together someday, given enough understanding, or education, or cars in our driveway.

So to be with, to form some semblance of friendship with, people who live on less than a dollar of consumption a day, is a window into the nature of a God who will redeem and restore. Somehow, mysteriously, the poor are blessed and the rich are blessed to be with the poor.

As the choir sang, danced, and prayed, they foolishly lift their chairs in the air professing a crazy vision of renewal and justice like Isaiah. And I, pretender that I am, do my best to join. It is through their eyes that I believe in a new heaven that is coming in a day and time unknown, and is also here and now for us all.

Life in the Desert

This is post 4 of 10 in the Broken:Beautiful series.                             

Blood:Water Mission has been working in a Kenyan region overlooked by governments, charities and markets. The Marsabit district is in the northern part of the country, sitting close to the border of Ethiopia. It is a landscape that is difficult to explain because it is a place of such extremes.

It’s not just hot, it’s oppressively hot.

It’s not just dry, it’s earth crumbling dry.

It’s not just poor, it’s extremely poor.

As you fly above the region, the land looks like the surface of Mars, or the Moon, not Earth. You can see spontaneous twisters of sand, dust and heat dancing across the barren landscape. You can feel empathetically thirsty just from looking at the vast desert. One man I know from Marsabit, named Yegon, says, “Welcome to Marsabit. There is life in the desert.” It’s hard to believe that people live here. But they do, alongside their camels, donkeys, and goats.

I remember the first time I came to visit Marsabit. I was amazed by the nomadic communities who travel days to find the remnants of vegetation for their animals to eat and to live, searching anywhere they could find water. It was nothing like Isaiah’s vision where all is well, peace prevails, and each has enough.

Last year, I brought some of our donors to come with me to Marsabit and see the work. We landed on a dirt airstrip in a place that felt like The Middle of Nowhere and traveled to one of the schools where we have worked. Prior to the visit, we had played up the wonderful water work we were doing in Marsabit. We told these donors about the rain catchment tanks, the oasis, and the boreholes. We were excited to show them the good work when we visited Torbi Primary School. The children greeted us with songs about water and recited poems about AIDS. At the end of our visit, we confidently walked to the water tanks to proudly take pictures. But the tanks were dry. You could turn the tap, but no water would show. Marsabit was suffering a severe and unexpected drought for more than a year and the storage had run out. All was not well.

We then drove to the site of the dam that has been constructed. As we walked up the hill, a goat was lying on the dusty sand, dead from dehydration. The ground below that was supposed to be filled with water was instead a cracked and crumbled prune of a landscape. We arrived at the rehabilitated borehole that we supported. More than 7,000 animals were coming to drink from this borehole because the water intended for human consumption was the only source there. The animals are the livelihood of our Marsibit friends, so now the people and the animals are competing for the same water source. Mothers, fathers, babies, and animals are continuing to fight the long defeat of a life with no water, which really doesn’t leave much of life after all.

I wished that the picture would have been different for our visitors, I longed for a world where provision justly meets need. Instead, we were hit by the reality of how hard it is to live in a place such as this, and how difficult it is to provide support to these communities. Had we failed in our attempts to serve our friends with water? It sure feels that way. It is humbling to realize that in places like Africa, the laws of Return on Investment just don’t translate. The forces of nature are beyond what most can comprehend. It can cripple even the strongest, most capable person.

As Americans, we are indoctrinated with a can-do attitude about almost anything. But there comes a point where human capability meets its threshold and you get a glimpse of the real truth about what we can and cannot do. We can raise all the money we need, mobilize the communities with excellent methods, train in best practices of hygiene, build solid latrines and construct fool-proof rain tanks.

But we cannot make the rain come.

We just can’t.

We are simply a part of this work, but ultimately, we are dependent on God to renew and restore the world.

I find myself asking if Yegon was right or if he was impossibly optimistic. There is no environmental mercy in a place like Marsabit. It’s a place that will make you question Isaiah and his vision. What is the eventual pay-off of hard work? When will men, animals, and the land be reconciled? Where is this God who hears his people? Is there any sensibility in hope? If I’ve learned anything about Marsabit, it’s that only the strong survive. That is the only life you will see in the desert.

In the midst of these questions, the empty tanks remind us all that water, whether from above or below, is the provision of God. And we remain faithful to the work, a shadow of what it means to be faithful to live in hope for a New Jerusalem even in the midst of such a drought. And looking closely, we see little bits of it coming. Certainly, life is hard when there is no rain. But if we pay attention, we are witnesses to the dignity, the hope, the community ownership and endurance that are empowering communities to work together to overcome these hardships. They are mastering a kind of emotional and psychosocial poverty that stands in the way of Isaiah’s vision.

We hoped that our visitors would understand the complexity of the work that we do here. I think they came away with that. I also have been reminded of it. I think we all come away with a deep cry inside us that the rain will come. So we get on our knees with our friends in Marsabit and pray deeply and desperately to God that the gift of water might be brought to this land.

Responding to Beauty

"Fall is staggering in, right on schedule with its baggage of chilly nights, macabre holidays, and spectacular heart-stoppingly beautiful leaves. Soon the leaves will start cringing on the trees, and roll up in clenched fists before they actually fall off. Dry seedpods will rattle like tiny gourds. But first there will be weeks of gushing color so bright, so pastel, so confettilike...

An odd feature of the colors is that they don't seem to have any special purpose. We are predisposed to respond to their beauty, of course. They shimmer with the colors of sunset, spring flowers, the tawny buff of a colt's pretty rump, the shuddering pink of a blush. Animals and flowers color for a reason - adaptation to their environment - but there is no adaptive reason for leaves to color so beautifully in the fall any more than there is for the sky or ocean to be blue. It's just one of the haphazard marvels the planet bestows every year."

- Diane Ackerman, A Natural History of the Senses

The Friday Five: Confessions of an iPhone Addict

I have a problem. I am an iPhone addict. It creates terrible habits. Here are five confessions of an iPhone addict (aka - Me):

1. Poor Bedside Manners I get into bed and grab my iPhone to set my alarm. Oh, but wait! What's the weather supposed to be tomorrow? Oh, and my calendar for the day? Hmm, has anyone at work sent me an email tonight? Well, while I'm at it, I forgot to respond to Joe - let me do that. Oh, someone tagged me in Facebook? I must see! While I'm at it, what about Twitter? Who won Thursday Night Football? Can't. Stop!

2. Dangerous Driver Apparently my life is so over-stimulating that driving a vehicle through roads and traffic is not interesting enough to keep me occupied. My mind races and I remember something I feel I need to respond to immediately. Quick, at a red light, shoot a text to someone to ease my anxiety. Bad move.

3. Dual Screen Consumer I watch television with my iPhone in hand? If the television is uninteresting enough to demand another electronic device for entertainment, why don't I turn the tv off? I DON'T KNOW!!

4. Long Line Lingerer Standing in line at Starbucks, my iPhone comes immediately out. Really? Why?! Folks, I have a big job with a lot of responsibilities like many of you, but I'm not so important that I can't look up at the people around me while I order a latte. It's just rude.

5. Bathroom Reader Gross. Need I say more?

Lord knows I need to change my ways. Next week, I begin a four-month sabbatical from my daily work at Blood:Water Mission, and part of the process is handing over my iPhone, which I did on Monday. I want to conquer this addiction and replace it with healthier habits. I'm cutting it cold-turkey, because my sabbatical is affording me the ability to do that. But I think we can all work to minimize the unhealthy habits of being an iPhone addict.

Are you a recovering iPhone addict? I would love your advice! How have you kicked some of your worst technology habits?

Broken

This is post 3 of 10 in the Broken:Beautiful series.                              Guest post by James Nardella

Before we imagine the just world of Isaiah 65, we must first recognize the broken, longing world we work in. Though Kenya is abounding in beauty it is also a place littered with trash that is never removed. A place where children are often damp with urine and dripping with snot and chase you with endless shouts of "how are you?" Their fingers reach to touch your skin to see what it feels like. A place where many young girls have their most precious and sensual parts cut off in a ceremonial welcome to adulthood. Where women are without rights Americans would consider inalienable: rights to full education, land ownership, decisions over child-rearing and marriage. And men have the right to marry more than one wife.

It is a place where funerals for young people are so common, they are casual community events. Where, last year, I watched school children mourn the loss of a young girl I knew, Christabell, who was taken by HIV. Where I have seen 6 babies die at birth. Where my friend Leah is down to one lung, because of TB and HIV, and lives by hope mostly.

In Kenya, roads are often impassable because of rain, and dangerous because of disrepair. It is a place where risky driving took the life of our intern, Brooke, along with two-dozen others. A place where breaking down is so common it goes without mention. Where gas and kerosene are carried carelessly in plastic bags, and 5 children died a few years back in house fires when on one day the fluid meant for cars was accidentally sold for lanterns.

Kenya is a place where latrines are stinking holes in the ground covered in excrement and buzzing with flies, and toilet paper is rarely found. Where hands of welcome are offered everywhere and are universally sticky with God-knows-what, but must be shaken nonetheless.  Those same hands prepare food tainted just enough with Typhoid some days to make you puke till you pass out. Where water itself contains sicknesses that kill more children than anything else and dangerous rivers are hop-scotched by women with babies strapped to their backs and jugs on their heads.

A place where officials are ubiquitously bribed and favors are rarely done without expectations. It is a place where I sometimes feel inexplicably defensive and irritable. Where stories are contrived for my listening white ears. Where everyone who approaches me seems to do so with a hidden hope: a child they want me to sponsor, a job they need, a service they want to overcharge me for. A place where cynicism is a daily sensation. Where it is only honest to admit to at some moments thinking the place is a shit hole. Or worse even: God forsaken. A place that forces the precarious conclusion that all men may be created equal, but all countries are not, all societies are not, and all communities are not. Where anyone might rightly question the promise of Isaiah.

It is in this disillusionment, that I see one truth clearly- all things are not yet right, the world in all its beauty, is scarred by inequality, people are dying unfairly, some are fat while others are scared sick that they will not have food for their children; some have clean running water while others have cholera. The world longs to be a New Jerusalem, cries for a God who will restore and renew all things.